Individual provider Active NPI

Lisa Sue Groves, RD, LMNT

  • Registered Dietitian
  • Omaha, NE
National Provider Identifier
1922035708
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
655 Issued in NE
Practice address
4101 Woolworth Ave
Omaha, NE 68105-1850
Phone
(402) 346-8800
Fax
(402) 977-5603
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 655 NE Primary

Addresses

Primary practice location

4101 Woolworth Ave
Omaha, NE 68105-1850

Mailing address

2108 Hedge Apple Rd
Plattsmouth, NE 68048-5675
Phone (402) 346-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
655NEMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922035708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 HEDGE APPLE RD",
            "city": "PLATTSMOUTH",
            "state": "NE",
            "postal_code": "680485675",
            "telephone_number": "402-346-8800",
            "fax_number": "402-977-5603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 WOOLWORTH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681051850",
            "telephone_number": "402-346-8800",
            "fax_number": "402-977-5603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVES",
        "first_name": "LISA",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "credential": "RD, LMNT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NE",
            "license": "655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.